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The ED patient, lying in bed in her own private room, picks up the all-in-one telephone handset and remote control beside her and calls her husband to tell him shes been in a car accident. She clicks on the 12-inch TV monitor, watches for a while, and then decides to switch over to the radio for some calming music.
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A recent study by a University of Michigan cardiologist on behalf of a Michigan-wide angioplasty research group produced a sobering statistic: Of 1,551 heart attack patients who had emergency angioplasty at hospitals in Michigan, women waited on average more than 118 minutes before treatment began, compared with 105 minutes for men.
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For the emergency physician, sexual assault represents the most common presenting complaint associated with the potential for an unintended pregnancy. Annually, approximately 40,000 people in the United States visit EDs after sexual assault. Pregnancy is estimated to occur in approximately 5% of sexual assaults. Thus, pregnancy prevention is an important part of the care for these patients. For the emergency physician, EC represents the most viable treatment option. However, while highly effective when used properly, it is associated with a number of issues that make it much less commonly used.
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The outcome of a medical malpractice case often depends on an experts opinion and how well that expert conveys that opinion to a jury. Despite the important role that experts play within the medical malpractice system, until recently, there has been little oversight of expert witness actions. With the increasing number of professional and legal actions against expert witnesses, it appears that the same experts hired to review the actions of their peers are starting to be scrutinized themselves. This months issue of the ED Legal Letter will address some of these issues that relate to the role of the expert witness.
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This article begins by reviewing the existing literature describing the epidemiology of rapid sequence intubation (RSI) in children as well as its affect on survival. The pertinent aspects of pediatric anatomy and physiology are reviewed. Finally, the various components of RSI in children including equipment, techniques, medications, and rescue devices are discussed.
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This two-part series discusses bacterial skin and soft-tissue infections. Part 1 will discuss bacterial skin infections that quite frequently are encountered in the general practice of medicine and that predominantly are benign in nature. With proper diagnosis and treatment of these entities, no major complication or long-term sequellae should be expected.
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In this article, a leading expert in the area of improving health care quality argues that restricting visiting hours in ICUs is neither caring, compassionate, nor necessary.
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Clinicians have been criticized for prescribing too much, as well as too little, sedation for critically ill patients, especially patients who require mechanical ventilation. Over-sedation may prolong weaning from ventilatory support, increase ICU and hospital lengths of stay, and predispose to development of ventilator-associated pneumonia. Inadequate sedation predisposes the patient to pain and discomfort and can evoke a stress response that compromises recovery.
